Despite significant advances in intensive care unit (ICU) care, delirium continues to pose a significant challenge. Delirium can be defined as an acute change in cognition and a disturbance of consciousness. Delirium affects up to one third of acutely hospitalized patients with medical illness, and over 50% of patients in high-risk populations. The most common causes of delirium include drug or alcohol withdrawal, medication use, or an underlying medical condition. The reason for frequently missed or delayed diagnosis of delirium is the fact that delirium can present with a combination of agitation, somnolence, withdrawal, and psychosis. In fact, patients often are misdiagnosed with anxiety and/or other psychiatric disorders before the correct diagnosis of delirium is made. The high morbidity and mortality associated with delirium serve to emphasize the critical importance of early diagnosis and treatment. Clinical management of delirium is multi-faceted, and includes the use of antipsychotic agents, benzodiazepines (mainly for delirium tremens), as well as environmental interventions, patient reorientation, and family-oriented educational efforts. This article provides an overview of considerations for diagnosis and treatment of delirium, focusing on the objective criteria and scoring systems used to identify delirium in the ICU.

Citation: Stawicki SP, Gerlach AT. Delirium assessment in the intensive care unit: An overview of objective diagnostic criteria and scoring tools. OPUS 12 Scientist 2008;2(4):13-16.

Keywords: Delirium, Intensive care unit, Scoring systems, Objective criteria, Diagnosis and treatment.

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